Our Treatments

What is a Facet Injection?

A facet injection involves injecting a small amount of local anesthetic (numbing medication) and/or steroid medication into the facet joint in order to block pain by numbing the facet joints. Facet joints are small joints at each segment of the spine that provide stability and help guide movement.

The facet joints can become painful due to a back injury, arthritis, or mechanical stress to the back. Facet injections usually have two goals: to help diagnose the cause and location of pain and to provide pain relief.

How does this procedure work?

You will be provided with light IV sedation or a small sedative to help with anticipated anxiety, however sedation is not required. You will lie on an x-ray table; the target area will be prepped and the procedure will be conducted under sterile conditions while using fluoroscopy (x-ray) guidance.

Fluoroscopy allows the doctor to watch the needle in real-time on the monitor to ensure the medication is injected into the desired location. Some discomfort may occur, but patients more commonly report experiencing a feeling of pressure versus pain. Once the procedure is complete, a band aid will be applied and the patient will be able to walk out of the office and continue with daily activity.

Medications injected include both a corticosteroid such as dexamethasone or methyl-prednisolone and an anesthetic numbing agent such as lidocaine or bupivacaine. A numbing medication will be injected into the facet joint; if immediate pain relief is felt while the facet joint is numb, this means that the joint is likely a source of pain. Along with numbing medication a steroid is injected into the facet joint which may provide longer-term pain relief. The injection itself only takes a few minutes, but the entire process may take between 15 and 30 minutes.

What are the benefits of this treatment?

The goal of this procedure is to reduce pain so that you may resume normal activities and a physical therapy program. Duration of pain relief varies, lasting for weeks or years, and is dependent on each individual.

How many treatments will i need?

Pain relief can last days to years, and is dependent on each individual person. This injection may be repeated every 3 months. Injections are performed in conjunction with a physical therapy and/or home exercise program to strengthen the back muscles and prevent future pain episodes.

What are the risks of this procedure?

Facet injections are considered an appropriate nonsurgical treatment for most patients. Potential risks associated with inserting a needle into the facet joint includes bleeding, injection, allergic reaction, and nerve damage/paralysis (rare). Corticosteroid side effects may include weight gain, water retention, hot flashes, mood swings, insomnia, and elevated blood sugar levels in diabetic individuals. Side effects are temporary and any numbness or mild muscle weakness usually resolves within 8 hours.

What is the recovery time of this procedure?

Once the procedure is complete, a band aid will be applied and the patient will be escorted to a recovery room where they will be monitored for a short time, and will be able to leave the office shortly after. Rarely temporary leg weakness or numbness can occur; therefore, you should have a driver attend the appointment with you to drive you home.

You will be able to walk immediately after the procedure and may feel slight discomfort, so it is recommended to take it easy for 24 hours and may resume full activity the next day. Soreness around the injection site is normal and may be relieved by using ice and taking a mild analgesic (Tylenol). It is a good idea to keep a record of your pain level during the next few weeks. You may notice a slight increase in pain, numbness or weakness as the numbing medicine wears off and before the corticosteroid starts to take effect.

If the facet joints that were treated are the source of the pain, the patient will have immediate pain relief from the local anesthetic and may begin to notice longer lasting pain relief from the steroid starting 2-5 days after the procedure. If the patient has immediate relief with the numbing medication, but does not have any longer lasting improvement with the steroid, further diagnostic test/treatments might be performed such as a medial branch nerve block or a radiofrequency ablation. If the patient does not have any relief with the numbing medication, further diagnostic tests may be needed to accurately diagnose the patient’s pain.